Measurement of food literacy among the adult population in urban Uganda and Kenya: development and validation of an East African food literacy scale.

OBJECTIVE

Food literacy (FL) is a potential approach to address the nutrition transition in Africa, but a validated tool is lacking. We developed and validated a scale to assess FL among Ugandan and Kenyan adult populations.

DESIGN

A mixed-method approach was applied: (1) item development using literature, expert and target group insights, (2) independent country-specific validation (content, construct, criterion and concurrent) and (3) synchronisation of the two country-specific FL-scales. Construct validity was evaluated against the prime dietary quality score (PDQS) and healthy eating self-efficacy scale (HEWSE).

SETTING

Urban Uganda and Kenya.

PARTICIPANTS

Two cross-sectional cross-country surveys, adults >18 years ( = 214) and university students ( = 163), were conducted.

RESULTS

The initial development yielded a forty-eight-item FL-scale draft. In total, twenty-six items were reframed to fit the country contexts. Six items differed content-wise across the two FL-scales and were dropped for a synchronised East African FL-scale. Weighted kappa tests revealed no deviations in individuals' FL when either the East African FL-scale or the country-specific FL-scales are used; 0·86 (95 % CI: 0·83, 0·89), Uganda and 0·86 (95 % CI: 0·84, 0·88), Kenya. The FL-scale showed good reliability (0·71 (95 % CI: 0·60, 0·79), Uganda; 0·78 (95 % CI: 0·69, 0·84), Kenya) and positively correlated with PDQS ( = 0·29 = 0·003, Uganda; = 0·26 < 0·001, Kenya) and HEWSE ( = 0·32 < 0·001, Uganda; = 0·23, = 0·017, Kenya). The FL-scale distinguishes populations with higher from those with lower FL ( = 14·54 (95 % CI: 10·27, 18·81), Uganda; = 18·79 (95 % CI: 13·92, 23·68), Kenya).

CONCLUSION

Provided culture-sensitive translation and adaptation are done, the scale may be used as a basis across East Africa.